The Bottom Line: Androgen treatment is a main aspect of clinical management in boys with hypogonadism from adolescence on up. Replacement therapy is necessary in inducing secondary sexual characteristics and adult male body composition, and for optimization of bone mineral content accrual and muscle mass, and in promoting physical and social well-being.
Bertelloni. Androgen therapy in hypogonadal adolescent males. Hormone Research in Paediatrics 2010 vol:74 iss:4 pg:292 -296
Replacement therapy should be administered with the follow recommendations: hormonal induction should start at the appropriate age for puberty; Since testosterone is the only sex steroid hormone able to replace all the physiological requirements it should be the only hormone used; age and pubertal stage should determine the dose; therapy should permit for the normal puberty tempo; steroid concentrations should be consistent with the stages of pubertal development, maintain appropriate serum levels of dihydrotestosterone/testosterone ratio and E2/testosterone ratio; and testicular volume is not increased by therapy; it may in fact be suppressed due to inhibition of gonadotropin secretion by negative feedback.
Table 1. Main causes of delayed puberty in males Page 293